Missing the litter box

You have a problem. Your cat is thinking outside the box, and not in a good way. You may be wondering what you did to inspire so much “creative expression.” Is your cat punishing you? Is Fluffy just “bad”? No, and no. House soiling and missing the litter box is a sign that your cat needs some help.

According to the Winn Feline Foundation, house soiling is the number one complaint among cat owners. The good news is that it is very treatable.

An accredited veterinarian can help you determine if the problem is medical or related to social or environmental stressors. In addition to a complete physical exam, the doctor will ask you specific “where and when” questions.

Health factors

Tony Buffington, DVM, PhD, a specialist in feline urinary disorders at The Ohio State University, and founder of the Indoor Cat Initiative says that many veterinarians recommend a urine test for every cat with a house soiling problem. The urinalysis will determine if blood, bacteria, or urinary crystals are present — signs that your cat might have feline lower urinary tract disease (FLUTD).

FLUTD is very common and can cause painful urination. Cats that begin to associate the litter box with pain will avoid it. Other medical possibilities include hyperthyroidism, kidney disease, diabetes, and arthritis and muscle or nerve disorders that might prevent your cat from getting to the litter box in time.

Environmental factors

If there is no medical cause, the next step is to look at environmental factors. Start with the litter box. Your cat might be avoiding the litter box because it is not cleaned well enough, you’ve changed the type of litter you use, or there is only one box for multiple cats.

Another possibility is that your cat is “marking” — spraying urine, typically on vertical objects such as walls and furniture, or in “socially significant” areas near doors or windows. Both male and female cats mark. The most common offenders are cats that have not been spayed or neutered.

Buffington says that stress can cause elimination problems too. For example, subtle aggression or harassment by other house cats or neighborhood cats may be an issue.

Even unremarkable changes in your home can make your cat anxious or fearful. Look around. Did anything change right before your cat started having problems? Did you get a new pet? A new couch? Maybe you just moved the old couch to a different part of the room, or had a dinner party. Cats are sensitive creatures and changes that seem small to you can throw your cat off his game. Check with your veterinarian about finding solutions that work for both you and your cat

SOURCE: https://www.aaha.org/pet_owner/pet_health_library/cat_care/behavior/missing_the_litter_box.aspx

Case of the Month: Clark

Clark is a 3-year-old male neutered domestic shorthair cat who presented to the Pekin Veterinary Clinic because he was straining to urinate and the owner was seeing blood in his urine (hematuria). He was also acting like he was in pain and was not eating or drinking at home. On physical examination, Clark's heart rate was greatly increased (tachycardia) and he had a large hard bladder on abdominal palpation. When Clark's abdomen was manipulated, he was extremely painful.

At this time, Clark was taken to our ultrasonography room to assess his bladder on the ultrasound and collect a urine sample by cystocentesis. The ultrasound showed that the bladder was very large, distended and contained a lot of foreign material. The urine sample that was collected revealed that the urine was very bloody and contained an abundance of what appeared to be crystalline material. The urine sample was sent into the laboratory for urinalysis. The urinalysis revealed that the bladder contained crystals (struvite) and blood from the inflammation of the inside of the bladder wall from the crystals.

Clark was in very critical condition, so it was decided between Clark's mom and the veterinarian that he needed to be treated as soon as possible for this condition. We started by collecting Clark's blood and assessing his kidney function and electrolytes. His blood work showed that both of his kidney values were highly elevated. His blood urea nitrogen (BUN) was 119 (normal range 10-30) and his creatinine was 9.8 (normal range 0.3-2.1). The electroyte that was dangerously high was potassium (this is a common bloodwork finding in cats who cannot urinate due to having stones lodged in their urethra).

Clark was immediately anesthetized to relieve his pain and so that we could unblock him by passing a sterile urinary catheter. We needed to unblock Clark as soon as possible to decrease his chance of complications from his condition. These potential complications included: bladder rupture from overextension of the bladder wall, irreversible kidney damage and/or adverse effects on the heart from the high potassium. Once anesthetized, we unblocked Clark's urethra which was blocked with multiple small crystals. After the urinary catheter was placed, we flushed that bladder with a mixture of sterile saline and lubricant to try to remove as many of the crystals from the bladder and urethra as possible.

A sterile urine collection system was placed on the end of Clark's urinary catheter so that his urine output and quality could be assessed. An intravenous catheter was placed in Clark's cephalic vein so that he could receive fluids to correct his electrolyte disorders and flush the kidneys to bring down the elevated kidney values. Clark was given oral pain medications to help keep him comfortable. He was also given an antibiotic to decrease his chances of getting a urinary tract infection as a result of the urinary catheter being placed. Clark rested for the remainder of the afternoon and evening without complication.